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HomeMy WebLinkAboutMiscellaneous - 19 CARTY CIRCLE 4/30/2018 19 CARTY CIRCLE 2101047.0-0017-0000.0 N2 1 3 5 Date../ TOWN OF NORTH ANDOVER 0 J.. , PERMIT FOR WIRING 14 to u This certifies that ...... ............................................................. has permission to perform ...... L4,1(1, 0 .A4 ........... . ........................................ wiring in the building of...... ......... ......................... C... .......... ,North Andover,Mass. at....... ..........C.q.�?.X. .......... . Fee.... ......e.. Lic.No./:3i?�Z , ............... ....... ............. 4 ic ��.......... NSPECTOR /^/ /`//// X/ WHITE:Applicant CANARY: Building Dept. PINK:Treasurer &J-e 1­0 WBice lyse Only --_ - nwealth of Massachusetts �- Perric No: Department of Public Safety _ Occupancy & Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 1200 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed In accordance with the Massachusetts Electrical Code. 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date �O -_ 145 City or Town of a y To the Inspector of Wires: The undersigned applies for a permit to perform a electrical work described be w. MAP AI Location (Street & Number) Owner or Tenant L�� �(/ sti(. PARCR Owner's Address Is this permit in conjunction with a building permit: Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building /` R S"o fit'✓T / L Utility Authorization NO. _ Existing Service Amps / Volts Overhead ❑ Undgrd❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd❑ No. of Meters Number of Feeders and Ampacity 1' Location and Nature of Proposed Electrical Work No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA Above In- ❑ .No. of Lighting Fixtures Swimming Pool grnd. ❑ grndGenerators KVA No. of Receptacle Outlets No. of Oil Burners No. of Emergency LightingBattery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges Total No. of Detection and g No. of Air Cond. tons Initiating Devices No. of Disposals No. of Heats Total Total No. of Sounding Devices Tons KW No. of Dishwashers Space/Area Heating KW No. of Self Contained Detection/Sounding Devices Municipal No. of Dryers Heating Devices KW Local ElConnection❑ Other No. of Water Heaters KW No, of No, of Low Voltage Signs Ballasts Wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: 5/'D, 4 INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES( NO E I have submitted valid proof of same to this office. YES[2—NO If you have checked YES,-please indicate the type of coverage by checking the appropriate box. INSURANCE BOND ❑ OTHER❑ (Please Specify) -T2/�0-rd2.L6('y�_ l d Expir tion Date Estimated Value of Electrical Work $ Work to Start Inspection Date Requested: Rough Final Signed under the penalties of perjury: FIRM NAME //++ LIC. NO. 1� � ,7 421,1 Licensee 2a�J��e j ` t Signature g e LIC. NO. Address UG{/p�� [ 61 e1iZ2 Btc.-.� Bus. Tel. No. !Zf--- / -{=-�Q ' Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its sub- stantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) ��� Telephone No. PE IIT FEE S Signature of Owner or Agent _W (> C e� Cq' m Do Not Write In Here 3 D CCA For Electrical Inspector Only c M r m r) Street and No. n DName ........................................................... Z Electrician .................................................... PermitNo. .................................................... Comments .................................................... �T, 1 b t 8 . ...Date... �� ,� NORTH ° °�<�``°;•'"° TOWN OF NORTH ANDOVER Oc PERMIT FOR WIRING ,SgACNusE� This certifies that } �l ./4 ` l I t....................................................................................... has permission to perform .........5 ....... .....•..................... wiring in the building of S v� J C4 2 C ( /2c �e at...../7...................... ...........................................,,With Ando. ,M Fee......V......... Lic.No.!t...s.. .................. .................... ... ......... LECTRICALINSPBCTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer i � r office Use Onty / T ( 1hi �iIIIIIIlI ulurafth of gnsa#aztts Permit No. C0 Y n Et)rIZIIiZ ult of�I1Sj:1lIL `m tg Occupancy&Fee Checked (' BOARD OF FIRE PREVENTION REGULATIONS 527 CAR 12:00 1 Mill (leave blank)) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Eiectricai Code, 527 C,L1R 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Z L Z Qi,X or Tawn of NORTH ANDOVFR To the Inspector at Wires: The udersigned accties for a permit top rform the eiectrtcai work described below. Location (Street & Number) 19 ��ieT/ el CL, - Owner or Tenant Cwner's Actress Is this permit in ccnlur.c:icn with a building permit: Yes _ Na (Check Aporconate ?cx) Fur�cse ct 5uiiCirc Utility Autmcnzation No. i Eh:snng Sar;ice Amos N/Clts Overneac Uncgrnc I No. at Meters N,e.v Service Amps t/Crts Cverr.enc _ unc'yrnc _ No. at Meters 'r NurnCer Jt reecers arc Amcac::y _cca-,:c;­, arta NatL.,. c' ?•CCCSea _:eC:....al .,1cr< ... _ Total No. - .ransrormers No. _. ...... �tvets Na. _. -... .-cs KV 'A �� K.A .g_ ..g . , Accve— In- No. v L.cnnng =xtures Sw,rrming ?cot KVA g.-r.a. _ arnc. _ Generators No. at Eimergency uigntirg No. ct c_cevac:e C.utiets Na. ct Cit .urgers 3arery Units No. --f Swrtcn Cutlets No. cr Gas _-.r.ers I =iP.E.a.:RMS No. atones i e Total Na. ct Cetec:ton arc No. = Raises Nc. Air C..r.c. tonsInittaug n Cavices -eat Total Total r,No. ct Cisccsais ! Ne•cf Pu_cs 'ns K:� I No. ct Scunc:ng Cevices No. of Seit Cantainea No. cf D,snwasners - ScacerArea Heanrc n'� I OetecnomiScuneing Cevices 4tunictoat Nea::nc Cevices cv I -coat Cannec•:=n Other Na. cf Criers _ No. or Na. at i ",:w vcitage ;.• j No. at '.Vater seaters :KIN Signs 3aiiasts Wir:nc I No. �ivcro massace -uCs No. ct Moters Total ? INSURANCE CvERAG=. ?crsuant :o the recuirements ar aassac-userns garerai Laws I have a current L;acinty Insurance ?otic'/ -nCr:c:ng :.• o:etec CceratiCns 'overage cr -Is sues:antial eCuivalent. YE_ = NO — I have sucmirea vatic crcet ct same to me Ctfics. YES NC _ It icu -ave cnecxea YES. --lease inatcate :he type at coverage -y cnecxing *.ne ao ocnate =ox. INSURANCE 3CN0 = OTLER = (Please Scec:�/) •. (Exotrauon Cater s:rrr.atec value of Exec:ncai 'Norx s • r 'Nerx :o Star, lnscec•:cn Data Raeues:ee: Rough Fnat Signea anter :ne Penalties at ;er)ury! =iRM vALtE � �d Ll�'G'T2t C- LIC. N0. J L tenses J .T!/ /a ��' _Signature ' 'C. NC. Actress //� �,�D��� Alt. .e1. No. OWNERS INSURANCc WAIVER: I am aware :rat :re ucensee toes rat nave :ne insurance coverage or its suostantial eautvatent as re- cu,rea ay .Massachusetts General Laws, ane :hat my signature on :n:s =errnit aecttcauon waives this reawrement. Cwner Agent (Please cnecx ones eiecrcne No. PERMIT FEE S _�-- Siar.ature cr CSnner cr Agenti N2 2 Li 8 Date.... TOWN OF NORTH ANDOVER !E� 0 PERMIT FOR WIRING 8 o Ui .T. ,SSACMuSEt This certifies that....... .............. .................................... has permission to perform .....................................6 ON Cm wiring in the building of..Z7=.... P.......... �a.............................Z r C> at..............:..........0� ............... .......... ............ ..... ,North Ando xe Fee'=Fr........... Lic No.............. .......... . . . ...4 ..........;0 ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK:Treasurer Office U"O..iv The Commonwealth of MassachusePern.rt nu. 020 occupancy 6[ fef Cbeck.d CS Department of Public Safety 3/90 (ie.ae bunk) BOARD OF FIRE PREVENTION REGULATIONS S27 C 1200 APPLICATION FOR meFORP) accordance Ali utork be ERMITWTOth e tElectricalts PERFORMELECTRICAL WORK Code. 527 CMR 12:00 1. (PLF_'%SE PRINT IN 12M OR TYPE '�ALL INFOILHATION) Date City or Town of A/. f"i i I d,;,) ,A To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. c Loation (Street b Number) `� /l 'iL"-f/ a Pe%/ O ter or Ienant ,� �c �1,Y7 i /1 6-;per's Address Cj vr'7 -e Is this permit in conjunction with a building permit: Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization NO_ Existing Service Amps / Volts Overhead ❑ Undgrd❑ No_ of Meters c 1 New Ser'g-1Ge Amps / Volts Overhead ❑ Undgrd ❑ No. of Y.eters Nu=be= of Feeders and Ampacity Location and Nature of Proposed Electrical Work No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA = No. of Lighting Fixtures 3 Swimming Pool Above ❑ In- g ❑ Z rnd. grnd. Generators KVA Y No. of Receptacle Outlets`G No. of Oil Burners No. of Emergency Lighting < Batte Units No. of Switch Outlets a No. of Cas Burners FIRE ALARMS No, of Zones o o. of Air Cond. Total No. of Detection and No. of Ranges N _ tons Initiating Devices m No. of Disposals No. of Heat Total Total W Pumps Tons KW No..of Sounding Devices J No. of Self Contained . No. of Dishwashers S ace/Area Heating KW e� P g Detection/Sounding Devices No. of Dryers Heating Devices KW Local❑ Municipal ❑Other ¢ Connection LL No. of Water Heaters KW No, of No. o Low Voltage Signs Ballasts Wiring o No. Hydro Massage Tubs No. of Motors Total HP /1/ .<.LJ C :•�.,i � G C �-f—_.L. �/ C.C.C�/ INSURANCE COVERAGE: Pursuant-to the requirements of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES NO E] I have submitted valid proof of same to this office. YES.0 NO If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE S BOIND F] OTHER [] (Please Specify) Expiration Dale/ Estimated Value of Electrical Work $ Work to Start Inspection Date Requested: Rough Final Signed under the penalties of perjury: FIRIM NA.1E IC. N'". Licensee 1l 9" cps Signature 'U 1LIC. NO. Address J GwS 1.�, p� rr, d?'Q O/J' c sus. Tel_ No. LLC/_ L '�7l Alt. Tel. No. 1/1441— f/Z!? OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its sjn- stantial equivalent as required by Massachusetts General laws, and that my signature on ttis pe^ic application waives ',his requirement. Owner Agent (?lease chec}: one) Telephone No. PERMI: S Location No. L9013 Date � NpRT� TOWN OF NORTH ANDOVER ? f • p n Certificate of Occupancy $ Building/Frame Permit Fee $ • °mob+,.,:�.. ,�' , �,SSACNUs t� Foundation Permit Fee $ Other Permit Fee $ - Sewer Connection Fee $ Via. 1 Water Connection Fee $ f Ail �)f7$ TOTAL I A-1- Building Inspector 7 9 7 01/12/99 14:40 30.00 RAID •3 Div. Public Works ANDOVER, MA PERMIT NO. �V� APPLICATION FOR PERMIT TO 13UIL1)********NOR I Al U'NO. 1.0I'.NO. 2. RECORD OF l)N'NERSIIIP DATE BOOK PAGE ZuhE IiBDIV. LOT'No. [( 1.0(:A110 �- PURPOSE O�FBUIIDINCi �� u� � tiL �jtywt� � ll�$ -CL jL1 OWNER'S NAME q � , NO.CM:5FORIES SIZE. UIVNER'S ADDRESS f V BASEMENT OR SLAB RD ANCI IITE(-I"S NAME "�_ SIZE OF FI.00R LIMBERS 2 3 81)11 DER'S NAME (5 SPAN DIS I ANCF TO NEARES"1 BUILDING DIMENSIONS Of SILLS DIS DANCE FROM STREET' DIMENSIONS 01:POSTS DISI ANCE FROM 1.OT LINES-SIDES REAR DIMENSIONS OF GIRDERS ARTA OF LOT FRONTAGE IIEIGIIT ON=FOUNDATION THICKNESS IS BUILDING NEW -'SIZE OF I(X7I ING a X IS BUILDING ADDI FIN MAIERIAL OF CIIININEY IS BUILDING ALTERATION � IS BUILDING ON SOLID COT11 LED LAND WTI.LBUILDING CONFORM TORFCKIIREMENTSOFCODE P ISBUILDINGCONNECIED-1O TOWN WATER BOARD OF APPEALS ACTION, IF ANY b J IS BUILDING CCNNNECI"ED TO TOWN SEWER IS BUILDING CONNECT ED TO NA I URAL GAS LINE INSFUCTIONS 3. PROPERTY INFORAIAI`ION LAND COST EST-. BLD(;.COST d� UCS P.-GE I FILL OU F SECFI(NS 1-3 EST.,BLDG.COST PER Sly.FT. EST. BI.IXi.COS IPER ROOM EI EC-TRIC METERS MAST BE ON OUTSIDE OF BUILDING SEPTIC PERMI 1 NO. A I'I ACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS 4. .-tpl'H OED BY: PIANS MUST BE FILED AND APPROVED 13Y BI)ILDING INSPEcroR BUILDING INSPECTOR DATE FILED ` �- OWNERS'IE..iA 8�-0 y CO NJ I'R.l FI.N l a o Lz- CONI-RA-K-4 (Z,— G-a' IGNAIIIRI:CH:t)WNI:It OR AtII1kN11Zl:DAGE N'I*ft _ _ //�� II.LC.P l C- �� 1.1.1'. l 30 H 10,11TO GRAN 11:1) 19 w i �-- _ � 2 � � � I �: r Town of North Andover t NORTH 14 OFFICE OF o •, �o COMMUNITY DEVELOPMENT AND SERVICES 9 • 146 Main Street r North Andover, Massachusetts 01845 ��.'•�:;;;�:•`,5 WUI-L, M J. SCOTT SAcHuStt Director In accordance with the provisions of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by NIGL c 1 11, S 150A. The debris will be disposed of in: t CSU C AAA - (Location of Facility) Signature of.'Permit Applican Date NOTE' Demolition permit from the Town of North Andover must be obtained for this project through the Once of the Building Inspector. BOARD OF APPEALS 688-9541 BUELDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9340 PLANNING 688-9533 The Commonwealth of Massachusetts -, Department of Industrial Accidents -= - Off=8f1,oyestlyatlons _ 1 _ . 600 Washington Street Boston,Mass..02111 Workers'.Compensation Insurance;Affidavit name: location- city phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole proprietor and have no one working in any.capacity ❑ I am an employer roviding workers' compensation for my eng)loyees working on this job. address- 70 lin- Ln e., GAA s:VOUX-Al: r-%7701 ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: company name• address: city Qhone 7 insurance'co. .. .•.�,. poli' ,. ,� c�pan, name: I • addresr. I t .'i:is`.::: ..... ... city: Phone;#: insnranre rn :'>E< E•.''?': `? p41SY.# Attacl>ra�nItfionsa'sneefJttiet essaCos Failure to secure coverage as required under Section 25A of MGL-,152 can.lead.to the imposiddplof criminal penalties of a fine up to 51.500.00 and/or one years'Imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a.tine of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the Ofllce of investigations of the DIA for coverage verification. I do herebyrrijy under the pains and penalties ojpedury that the information provided above is true and correct Signature �` �-� Date Print name Do %V% C, Ta Yhone# q44- - 8043 official use only do not write in this area to be completed by city or town olIIcial y city or town: permitlucco"# nBaiiding Department .j ❑Licensing Board (7 check if immediate response Is required OSelectmen's Office E36eaitb Department contact person: phone#t rnOther (m med 3/95 P1A1 r _ w __...�.�fe'{oai�:rnaoouueal!! a�✓�raaac�cuiell` DEPARTMENT OF PUBLIC SAFETY CONSTRXI,WKSUPERVISOR LICENSE Hui FExpires: Birthdate: 4.91.42/01/2000 02/07/1941 �tse e4fb 00 - LO TSt ANgtr 11'DEBORAH DR- r ;i READING, MA 01867 RestrictedTo� : 00 00 - 35 W ci ilICU ed ;Ace.- -62 Tot ed�tiQ,a of toe is cause forpc�tWW thi;�1> e.:'. 1 HOME IMPROVEMENT CONTRACTOR _ Registration 109565 Type - INDIVIDUAL Expiration 09/21/98 LOUIS GRANDE 11 DEBORAH DR DOING MA 01867 ADMINISTRATOR J r10RT Town of _ Andover No. Q Q3 o z LANE A dover, Mass., 19� yy COCMIC HE WICK '�`t - OA-4TED U S' U BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT...........4.tw ..a)............. .�............. .... ................. ............ . Foundation has permission to erect.... . . .................. buildings on ......... .. .................. '' ....... .. ...... /.. C .. Rou h Rough to be occupied as...,l.. .BATWAAD......... o ....... '......�.......go Gift .. ... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough r2�L� 2 q J PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRU N ART Rough . C ..... ..... .. .... ........... ... .... ............... .................................. Service BUIL ING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. ol�C?, .+ ILC CLQ Loca'cion Ni. 4��1 Date 10RTh TOWN OF NORTH ANDOVER - p Certificate of Occupancy $ * ; Building/Frame Permit Fee Foundation Permit Fee $ 3,CMUSE Other Permit Fee $ s Sewer Connection Fee $ Water Connection Fee $ F TOTAL , ,, Building Inspector 1. 0 �ti9lr.9 34.00 PAID Div. Public Works AD R31ee No. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP+40. LOT NO. 2 RECORD OF OWNERSHIP IDATE BOOK ;PAGE ZONE SUB DIV. LOT NO. LOCATION PURPOSE OF BUILDING OWNER'S NAME NO. OF STORIES 312E OWNER'S ADDRE BASEMENT OR SLAM ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND - 3RO BUILDER'S NAME SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES- IDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING x IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS.BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREME TS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER - IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES .� EST. BLDG. COST PAGE I FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS I - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR P;/TE FILED uWILDING INSPECTOR 1YATURE OF OWNER OR AUTHORIZED AGENT r F E E �� OWNER TEL R PERMIT GRANTED 19 CONTR.TELR CONTR.LIC.R` MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTINIGf (Print or Type) 1 l NORTH ANDOVER Mass. t Date 93 Building Location fq.,r. Ot rc (< Permit i( t Owners Name • - New 77 Renovation Replacement Plans Submitted 0 FIXTO__SS rn -. � W N Z N ao v a t- a F G1 W F- d Y x " O E— to d 4l y < 0 0 = O z !— W w F y; a cc w 4 N N a V u�t z = Q tL 0 G y to O FW W J N cc i• Iw' y. O 2 2 W O N x U. 2 d W Q a •• N Gi O Q ,t:r > C W O 2 Q Q 4 Q O O W - O W F+ c= x v tti Y u. x v ra ,s v ¢ y a a t- o BASEMENT IST FLOOR 2HO FLOOR 3110 FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR —171 (Print or Type) n Check one: Certificate Installing Company Name IAr4 t� �� �t- Q Corp. Address r Partner. Firm/Co. Business Telephone: Name of Licensed Plumber or Gas Fitter Insurance Coverage: Indicate the type of insurance c verage by checking the appropriate box: Liability insurance policy lion Other type of indemnity 0 Bond Insurance Waiver: I , the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance coverages. Signature of owner/agent of property Owner 17 Agent 1 hereby certify that all of the devils and information 1 have submitted (or entered)in above applicatio re true nd accurate to the knowledge and that all plumbing Work and instillations performed under*Permit isseed for this appiicatio will-be compliance wi pertinent provisions of the hLaachusetts State Gas Cude and Chapter 142 of the Genual Laws. By TYPE LICENS Plumber Title Gasfitter- Signa of Licensed City/Town- Master Pi „ rlor Gasfitter Journeyman 6r APPROVED (OFFICE USE ONLY) License Number • Date. �. �... . .. ... . . .. .. . . NORTH TOWN OF NORTH ANDOVER f 1 0� y� " PERMIT FOR SAS INSTALLATION �9SS�CNUSE� This certifies that . �. . 1.993. . has permission for gas installation !! . . . . . . . . . . . . . . . . . . in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at /. .'. . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . ., North Andover, Mass. Fee. Lic. No../ :. . :!. . . . . . . . . . . . . . . . . . . . . . . . . . . . . GAS INSPECTOR WHITE:Applicant CANARY: Building Ddpt. PINK:Treasurer GOLD: File c r Date. 12 3919 �? : ORTM, OOL TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING II �SSAC04USEt This certifies that I� has permission to perform . . . .R P . . . . . . . . . . . . . . . . i; plumbing in the buildings of . . . . . . . . . . . it -'h ; �,. . . . , North lover, Mass. I, at. . . �L . . . . . . . . . . . . . . . . II_ Fee. Lic. No../!' 7!4- . . . . . . . '�.. . . . .� . . . . PLUMBING INSPECTOR I 20.00 PAID WHITE,Ap� l� nt;441 CANARY: Building Dept. PINK:Treasurer (Type or Print) ,,•;�:., .;, . NORTH ANDOVER ,Mass. �- Oate: •1 D Building Location s Cc1 G"� L Persalt Owners Name t_ i .��. ..� •_!� y, Nti L ►� •v New D Renovation Replacement [J Plans Sybmitted ❑ '.� FIXTURFS ' z Y t to 03 o z I— a '° W V r to a d ¢ t; O W W of 1•• U Y < Ql W tZ ~ W lA -+ p a O 93 Q �, q t- h z ¢ a o < < Q V Z O O tr Q W Q W a Q 93 = Q 0. aG J W z < Y 3: d Z x Y n p f' 2 Z < W tc X W • . f— U } F' 0 N N 7 N t Z O Q of •. W I- O V X Y J m W o Q J = M• (a IV O O < i 'C o O SUB—+BSMT. � BASEMENT IST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR bTHF.LOOR 6TH FLOOR TTH FLOOR 8TH FLOOR (Print or Type). Check one: Certificate Installing Company Name E?�cw AddressPartner._ Firm/Co. Business Telephone S Name of Licensed Plumber:_Zoc/v Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: _. Liability insurance policy ©type of indemnity 0 Bond ❑ Insurance Waiver: i , the undersigned, have been made aware- that the licensee of i this ap lication does not have any one of the above three insurance coverages. �• I ggnature of ownerlagent of propert Owner U Agent. Eq I Umbr cutify Wal all of Ute dclailt and Woo nialion I ha.c tulain illcd fo(cntucd)in almoc applitalioo aae art wjd :&44 W d)N batt r r1 �. • knowkdgtt sod"all plumbing walk and inslallatinna lkt(nenacd undcr ruutil.ltsued(os this appticalioa wi0 be Ila irrl�N1a11A�itlt W pstt{Niw('1�►� lrlsis"of Ws bUu"Au=ttt Aatc 1'lumbias Codc and Cluptcl 142 of the(:cnual UW L .� i By Title . Signature of Licensed Plumber Type of Plumbing License City/Town: l 015 `44"A II w License Number Master ❑ Journeyma A DDPOVFr1 7OFFI(`F USE ONLY1 VI Date.. . . . . . . . .`. .,. . . ... . . Of ,ORTh TOWN OF NORTH ANDOVER 40 PERMIT FOR GAS INSTALLATION SACHUSEt This certifies that . . Y°.t l j' ' has permission for gas installation . . . . . . . . . . . . . . . . . . . . . . . . in the buildings <. .: . . ://.: . . . . . . .. . .. . . . . . . at . . . . . . . . , North Andover, Mass. r Fee. Lic. No.. . . . . . . ��. . . . . . GAS INSPECTOR Check#- /1 3 : 76 lir ^ MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) PC) CPN,00Vr; ,Mass. Date 20 G'— Permit#_3 VC Building Locationf C AEZT 1' C1IQC-L C owners NameH3 14AQCQVG-A7- Y Type of Occupahcy Du%E_LI1Ai:�- � New Renovation❑ ReplacementX Plans Submitted: Yes❑ No❑ rn U) W YZ Z In W O to co Z J G' FW" O } Z Z c F Q O W Q O O Z FQW- 0: vs (9 V n = y Z 0 O > W C7 FW- Z J H 2 F=- FW- W Q > LL LU H W J W W o 0 LL o U X > o Oa o sur BASEMENT 15T FLOORl 2"FLOOR 41K FLOOR 5'FLOOR 51H FLOOR 71"FLOOR 3111 FLOOR J installing company Name y W-1 one- ceFdflcais– Address h�—&p9)t'r� 1�X69 P 191uD6b ICA ❑ corporation s7 Business Telephone—Cl 7dt 7S– �3Yf2-9'- p(Partnership `6•' Name of Licensed Plumber or Gas Fitter ,fiw5C1911 4,y,, ❑ Firm/Co. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent, which meets the requirements of MCL Ch. 142. Yes X NO ❑ If you have checked yes; please indicate the type of coverage by checking the appropriate box. A liability insurance policy Other type of Indemnity ❑ Bond ❑ OWNER'S INSURNACE WAIVER: i am aware that the licensee does not have the insurance coverage required by C hapter 142 of the Mass.General Laws,and that my signature onIs permit application waives this requirement Check one: Signature of Owner or Owners Agent Owner ❑ Agent ❑ I hereby certify that all of the details and Information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and Installations performed under the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General La oL_-_ Typg of License: �" ^' By J Plumber S gna of Licensed P ber or Gas Fitter Title City/Town ❑Gasfltter A )(Master License Number / G fj d APPROVED(OFFICE USE ONLY) 0 Journeyman Date. ".O R7:�� TOWN OF NORTH ANDOVER 'a p PERMIT FOR PLUMBING ,SSACHUS� This certifies that ��`�<1���`. .'. . 1. .l►.�. �. . l. . . . . . . has permission to perform . . . . . .(--,r . . . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . . . . . . . . . . . at. . . . . . . . . . . . .. North Andover, Mass. Fee.,KU. Lic. No..( . . . . . . . . . . . . . "`Tl!�. . . . . . PLGMBING INSPECTOR Check # /? `/ ? z 5186 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING tPrint or Type) _ N v ��/�'` c� (/L=f�-- Mass. Date 3 2� 19_e ~ Permit # S: 8"6 ` I Building Location l5 C COPT I' C-/RIC t-L' Owner's Name MSF(, yaj!a,)T 1 yv - /1 Type of Occupancy D W L4` New ❑ Renovation ❑ Replacement/(( P_Jans-Submitted: Yes ❑ No ❑ B .P .# SEWER# FIXTURES SEPTIC# Z Y F 01 U3 V3 N O Z > S4 S4 to Z N Q ¢ ¢ ~ O Z W ¢ u u CL O - W ~ W y F U ¢ h 4 to U. Z - Z a, AC = W N X - 2 E ¢ m ¢ < Z ¢ d O Q - < U = � to W ?- P. Vf - ° < m Z ¢ a ¢ O Cz.� ¢ W O = d N ¢ < W J u d FF- O N N N Z O O H - W F" O U b < < S d Q O < J J d ¢ ¢ rL Q f1 G y IL 0 sus—BSMT. `r BASEMENT !' IST FLOOR 2ND FLOOR 3RD FLOOR ' 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR Installing.Company Name1jG ty rl"�4 Check one: Certificate # Address_ JY `1 `�a �l- I-jy f� 4 A� ❑ Corporation N 0 ✓IZA )L/W,5 v Partnership `FCP Business Telephone 5 7 � 3 Z Y ❑ Firm/Co. Name of Licensed Plumber 110 S 004 INSURANCE COVERAGE: I have aceus ❑ current liability Ins nce policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Y If you have checked Vis, please Indicate the type coverage by checking the appropriate box. A liability Insurance policy Pe Other type of Indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. Signature o censed Plumber rrtie Type of License: Master�yr Journeyman ❑ City/Town_ G 3 `s 11APPF�ED(OFFICE USE ONLY) License Number